Using the symptom distress thermometer (SDT) in patients with breast cancer to identify psychosocial supportive needs.

Abstract

200 Background: Psychological distress is common among cancer patients. In order to optimize patient care there is a need to understand the type of patient problems contributing to distress. SDT is a well-recognized tool for assessing distress in 5 broad problem categories including, practical, family, emotional, spiritual/religious, and physical (NCCN distress guidelines: Cancer 2005). The objective of this study was to evaluate categories of distress commonly experienced by breast cancer patients undergoing radiation therapy (RT). Methods: This is a retrospective study on patient symptoms of distress as recorded on SDT surveys. Patients completing SDT have the opportunity to score distress on a scale of 0-10 and list the category of distress. For the purpose of this study, we defined low distress score to be ≤ 3, and high distress score of ≥ 4 requiring referral/intervention. Patient population included 121 patients receiving a 3-6 week course of breast RT and who completed ≥ 2 weekly surveys during therapy. A total of 433 surveys were reviewed for score and category of distress. Results: Median age was 56 years (range 32-88). Each patient completed an average of 3.58 surveys. The median distress score was 3 (range 0-10). Overall distribution of any distress by problem category was 1.6% spiritual/religious, 3.7% family, 10.6% practical, 23.3% emotional, and 60.8% physical. Further, we noted that 63 patients (53%) described a high distress score (≥ 4). Among this cohort, 47 patients (74.6%) reported that their distress was secondary to emotional problems. We observed no association between high distress score and patient age or stage of disease. Conclusions: Physical problems were the most common symptom reported on SDT in our study population. However, among the patients identified to have high distress score, emotional problems emerged as the most common cause of distress. These observations suggest that although patients undergoing treatment have many physical complaints, the more significant symptoms requiring referral/intervention were in the emotional category. The identification of more significant problems experienced by patients would help optimize their psychosocial supportive needs.